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Pharm Exam 7
Digoxin Mechanism and Indication
Direct inhibition of Na K ATPase
Indirect inhibition of Na Ca exchanger
Increase Ca in cell
Positive Inotropy
CHF
Stimulates Vagus Nerve
Decreased conduction at AV node
Atrial Fibrillation
1 min
Acute Digoxin Toxicity
Clinical Symptoms
Hyperkalemia
Cholinergic (Nausea, Vomiting, Diarrhea)
Blurry Yellow Green Vision with Halo of Light
Arrhythmia
Bradycardia
EKG Changes
Prolonged PR interval
Decreased QT
Scooping on EKG
T Wave Inversion
2 mins
Digoxin Toxicity Treatment
Activated Charcoal
Slowly Normalize K+
Digibind (Anti-Digoxin Fab)
Magnesium Sulfate
Lidocaine
Cardiac Pacing
2 mins
Dobutamine
Mechanism
Beta-1 Agonist
Inotropic
Indications
Heart Failure
Side Effects
Tachycardia
Arrhythmias
Considerations
Closely Monitor Patients
Other Meds May Increase Potency
1 min
ACE Inhibitors
-Pril Suffix
Indications
Hypertension
CHF
Diabetic Nephropathy
Mechanism of Action
Inhibits ACE
Decreases GFR
Inhibits Constriction of Efferent Arteriole
Side Effect
Increased Bradykinin
Cough
1 min
ACE Inhibitor Toxicity
CAPTOPRIL Mnemonic
Cough
Angioedema
Potassium Changes (Hyperkalemia)
Taste Change
Hypotension
Pregnancy Changes
Rash
Increased Renin
Lower Angiotensin II
2 mins
Angiotensin Receptor Blockers (ARBs)
-sartan suffix
Indications
Hypertension
CHF
Diabetic Nephropathy
Mechanism of Action
Angiotensin II Receptor Blockers
Side Effect
Hyperkalemia
Contraindication
Pregnancy
1 min
Hydrochlorothiazide HCTZ
Mechanism of Action
Inhibits Reabsorption NaCl and H2O
Indications
Edema
Mild to Moderate Hypertension
Side Effects
Hypokalemia
Hyponatremia
Dehydration
Hyperglycemia
Gout
Contraindications
Sulfa Allergy
Pregnancy and Breastfeeding
1 min
Loop Diuretics
Mechanism of Action
Thick Ascending Limb of Loop of Henle
Inhibits Na+-K+-2Cl- Symporter
Sulfa Drug
Drug Names
Furosemide
Lasix
Side Effects
Gout
Ototoxicity
Hypocalcemia
Hypokalemia
4 mins
Spironolactone (Aldactone)
Mechanisms
Inhibition of Aldosterone
Potassium Retention
Indications
Hypertension
Edema
Heart Failure
Side Effects
Hyperkalemia
Endocrine Effects
Consideration
Avoid Potassium Supplements
2 mins
Hydralazine
Indications
Reduce Afterload
Severe Hypertension
Safe during Pregnancy
CHF
Mechanism of Action
Increases cGMP
Vasodilates Arterioles
Side Effects
Drug-induced Lupus
Reflex Tachycardia
1 min
Nitroprusside
Mechanism of Action
Direct Release of NO
Increase cGMP
Short Half-Life
Indications
Malignant Hypertension
Side Effect
Cyanide Toxicity
1 min
Nitroglycerin
Indications
Pulmonary Edema
Angina
Mechanism of Action
Decreases Preload
Releases NO in Blood
Side Effects
Hypotension
Reflex Tachycardia
Flushing
Monday Disease
Contraindications
Viagra (Sildenafil)
2 mins
Selective Beta-1 Blockers
Characteristics
"-olol" Suffix
Drug Names
Beta-1 Selective
Atenolol
Esmolol
Metoprolol
Partial Beta agonists
Acebutolol
1 min
Nonselective Beta-Blockers
"-olol" Suffix
Nonselective
Propranolol
Timolol
Nadolol
Partial β Agonist
Pindolol
Nonselective β with α Blocking
Carvedilol
Labetalol
2 mins
Syndrome of Inappropriate Antidiuretic Hormone (SIADH) Pharmacologic Interventions
Diuretics
Hypertonic IV Fluids
Demeclocycline
Tolvaptan and Conivaptan
1 min
Class I Antiarrhythmics (Na+ Channel Blockers) Overview
Indications
Arrhythmias
Local Anesthesia
Mechanism of Action
Block or Slow Conduction
Block Na+ Channels
Raise Threshold
State Dependent
Contraindication
Hyperkalemia
1 min
Class IA Antiarrhythmics (Na+ Channel Blockers)
Indications
Arrhythmias
Mechanism of Action
Increase AP, ERP, and QT interval.
Drugs
Disopyramide
Procainamide
Drug-induced Lupus
Quinidine
Cinchonism
Shared Side Effects
Thrombocytopenia
Torsades de Pointes
1 min
Class IB Antiarrhythmics (Na+ Channel Blockers)
Indications
Arrhythmias
After Myocardial Infarction
Mechanism of Action
Affect Ischemic Tissue
Decrease AP duration
Drugs
Mexiletine
GI Upset
Lidocaine
CNS Depression
Tocainide
Phenytoin
Hirsutism
2 mins
Lidocaine
Mechanism
Blocks Na+ Channels
Indications
Ventricular Arrhythmia
Anesthetic
Side Effects
Paresthesias
Seizures
Respiratory Depression
Drowsiness
Consideration
Anesthetic Effects Extended with Epinephrine
1 min
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